Saturday, 29 October 2016

The past few hours though, I've been remembering the hours before 4:32am on October 29th: labour.

I listened to a lot of Moya Brennan. She helped me to be level and calm (as much as is possible). To be honest I can't recall a particular song I heard. But it was a very long labour, and I went through most of my playlist. "Perfect Time" was certainly one of the songs I listened to. And I've been listening to it and thinking about the message lately, and how it really is still so appropriate for my life and all its questions and challenges.

Wednesday, 26 October 2016

Back when I started this blog, I thought I'd be writing a lot about fertility treatments. It seemed logical; we'd been told we would not conceive without IVF and had been referred to The Fertility Clinic. I spent a lot of time reading about (mainly) IVF and considering how I felt about medical intervention. As it turned out, I barely wrote anything about fertility treatments. The feelings I had to learn to process were entirely different.

This is not a bad thing, but it does feel a bit odd to be writing about fertility treatments now. Despite my five year journey with sub-fertility this feels new (and uncomfortable).

My first cycle with Clomid has ended. It didn't result in a pregnancy, but other than that, there was some good, some bad (as per usual).

The good:
I had signs of successful ovulation, and they all happened around the same time:

Abundant CM days 10 through 12 (mainly watery, but I'd read that Clomid dries up CM and that didn't happen in this case)

Positive OPK on day 12

Temperature rise 1-2 days after positive OPK (not sure when it started as I had poor sleep the first day after OPK. But definitely rose in the days after)

Blood test on day 21 showed progesterone at 11.3, which nurse said indicated ovulation (anything over 10 is considered sufficient)

The bad:

I had a sonohysterogram on day 12. This was not related directly to the Clomid cycles (they are not monitored with ultrasounds) but to check on the fibroid which a previous ultrasound had shown possibly intruding into uterine cavity. I had to call in to schedule this test on day 2 (the same day I start the Clomid). I'd assumed they would put it earlier in my cycle and was not too happy when they put it on day 12, as that's close to when I typically ovulate (in so far as I'm typical). I had already started the Clomid, but this meant we couldn't "start trying" till the test was done. I decided to go ahead with test anyway, since I don't know for sure when I'll ovulate (but as it turned out I was right, or close).

The procedure began with an internal ultrasound performed by a technician (my 3rd this year....sigh) She then went upstairs to get one of the fertility doctors, "Dr. Irish" (not my regular doctor; they take turns doing this procedure). He did the sonohysterogram in the cheerful nonchalant manner doctors (especially male ones) tend to adopt when they are up one's privates. The sonohysterogram went OK. I was mainly concerned about getting some results. Getting an appointment with Dr. Cotter takes six to eight weeks, which is a giant pain when we are waiting on results. It bugs me that people do tests on my body, especially invasive ones like this one, and then I can't know the results for weeks and weeks (and I know they have them). So I was quite anxious to hear at least something about these scans.

Dr. Irish, cheerful as ever, assured me that the sonohysterogram results looked good: the fibroid is a non-issue. "You have a pretty big cyst on one ovary, but the uterine cavity looks great." And breezed off.

Wait what? In hindsight there's all kinds of questions I would have liked to ask:

What do you mean, cyst? I had had my positive OPK that day: did he see a lead follicle ready to ovulate? or another kind of cyst? How do you tell the difference?! (both normal follicles and abnormal ones are called cysts....because that's not confusing at all.)

Could Clomid have caused the cyst?

Will the cyst interfere with my cycle and/or ovulation?

Will the cyst affect the next Clomid cycle?

But I didn't have the presence of mind (or the background knowledge of cysts) to think of these questions especially when lying on the table half naked. For some reason being in this position affects my ability for analytical thought and self-advocacy. Maybe I haven't had enough practice. Dammit! Two minutes after Dr. Irish and the nurse made their exit, I was frantically googling ovarian cysts on my phone.

Oh, one more bad. Despite the positive progesterone result, my cycle ended on day 23...at least four days sooner than it should have if I was right about ovulation (pretty sure I am).

I finally decided that before I take Clomid again (that should be right now, or yesterday), I want to ask about that cyst and if it's a good idea to start it again. I'm not monitored for cysts, but they are a side effect of Clomid and I happen to know I did have one (although not what kind it was). Everything I've read about Clomid, or for that matter any fertility treatment, and everything I've heard anecdotally says you do not start a treatment, you DO NOT PASS GO, if there's a cyst. So I'm not comfortable making the decision to start Clomid again without a doctor's opinion. The nurse I talked to could not give me advice, but she said she would leave a note for Dr. Cotter and ask for her advice. So I hope I hear back from them; I could really use the reassurance. This feels like sort of a test of The Fertility Clinic to see how helpful they really are, too. Sigh. As I noted before, I really don't feel good at this stuff. I admire all the IFfers who have learned to advocate and make decisions about these kind of things.

Well other than that. AJ turns two this week. So I will write something more cheerful next time.

Update:
Dr. Cotter called me back. Of course I was in the middle of teaching and when I see the phone number, I say "sorry: got to take this call" and sweep out of the room to have a conversation about my ovaries. Luckily I have educational assistants who can step in during awkward moments. Well I have to laugh at it because what else can I do.

The information I received as I understood: Dr. Cotter reviewed the ultrasound/sonohysterogram results and gave her opinion that the "cyst" was the maturing follicle (why Dr. Irish didn't just say "follicle" I don't know....). She even told me the sizes that they saw; one was 18mm I think. She said that was not big enough to qualify as a problem cyst. So basically, my body was doing what it was supposed to do, and the Clomid was working as expected. I brought up the short luteal phase: thank you to those people who have told me to ask about that. She said "do you know when you ovulated?" I said yes, pretty sure, because I had a positive OPK and charted temperature. Her explanation was that sometimes in people with low AMH, the follicles "don't behave as they are supposed to," and reminded me that while I'm still relatively young, I have poorly functioning ovaries. I asked about progesterone supplementation, as I'd heard that's sometimes used in similar cases. Dr. Cotter said "yes we sometimes do that," but that it doesn't necessarily make any difference. She said that since this was the first Clomid cycle, she would like to see how I respond to another one first.

Fair enough. It was a good (if perforce quick) conversation and helps me to worry less. (I really need to bring down my stress level about all aspects of life.) Also I can go ahead with Clomid this cycle: will be starting day 3 instead of 2 but she said that was fine.

Thanks to commenters for the emotional support and suggestions of what to ask about! I'm glad I did get a response and it's shown me I have to keep advocating for myself.

Monday, 3 October 2016

Five am seems to be when my internal clock has decided I'm going to wake up: weekdays, weekends, days with commitments and schedules, days without commitments and schedules. Six am is when I have to wake up on workdays, and at least an hour later on weekends, so I'm losing between one and two hours of sleep every night, and it sucks. But I'll try to take five minutes and write a microblog, at least.

I've had numbers on my mind the past couple of days. I'm starting a new cycle, which means entering and changing data in various places: phone reminders, Ovacue, the unpublished blogs I write about my physical minutiae, scheduling appointments and entering them into my calendar, counting OPKs to see how many more I need (I need a lot), and this time around, setting up a chart again. I haven't done one of those in a long time; I have just been keeping running notes. I hadn't logged in to the charting website in a long time and there were a whole bunch of charts from 2012 and onwards. I deleted them.

Maybe that's what reminded me that we've been trying for a child since fall of 2011, or five years. I started the blog in 2013, which doesn't seem that long ago. And AJ was conceived a year after the blog started, which again isn't that long. It's almost two years since she was born, not that long. But five years somehow sounds like a long, long time.

In those five years we've had one pregnancy and birth. Amazing and miraculous and blessed, that event, and I wouldn't trade AJ or whatever unusual circumstances led to her existence for anything. On the other hand, it's not so hard to imagine what could have been in five years. Two children easily, maybe three. And five years is a lot of cycles, charting, hope, disappointment.

It also raises the question: When is it time to stop? Not yet, not this month, nor probably the next. But five years. Five years.

Me, five years ago. This place no longer exists as pictured, it was destroyed in a 2013 flood.

About Me

Call me the Turtle. I started this blog to narrate our journey to transcend infertility. Mr. Turtle and I are in our mid/late 30s. In 2013 we were diagnosed with both female and male factor infertility (premature ovarian failure and low sperm count/motility). Fertility testing put our chances of unasssisted conception at close to zero with limited treatment options. After a cancelled IVF cycle in early 2014, I became pregnant unassisted and we welcomed baby AJ Turtle in October 2014. While enjoying life as new parents, we continued to explore options for expanding our family, but without solid reasons to hope any of them would work. In spring of 2017 however, what felt like two years of reproductive gambling paid off with a second pregnancy.